Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan.
Int J Hematol. 2010 Nov;92(4):579-86. doi: 10.1007/s12185-010-0696-4. Epub 2010 Oct 7.
We conducted a retrospective collaborative investigation of bortezomib (Bor) plus dexamethasone (Dex) therapy (BD Tx) for 88 relapsed or refractory (Rel/Ref) MM patients at six institutes. One cycle BD Tx comprised of Bor (1.3 mg/m²/day) on days 1, 4, 8 and 11, and Dex on days 1, 2, 4, 5, 8, 9, 11 and 12, every 21 days, and the mean number of BD Tx cycles was 3. The overall response rate was 66.9%, the median overall survival (OS) was 510 days, and the median progression-free survival (PFS) was 113 days. Attainment of partial response (PR) with the first course of BD Tx associated with the longer OS and PFS and late good responder, while no patient who did not achieve PR with the first cycle attained better than very good PR (VGPR) with the subsequent BD Tx. Patient age of less than 64 years old also associated with the longer OS and PFS. In addition, both an earlier disease stage and Dex dosage had a significant impact on OS, while the attainment of VGPR within 2 cycles had a significantly longer PFS. Earlier BD Tx courses may be predictive for the subsequent therapeutic pathway of Rel/Ref MM.
我们对六家机构的 88 例复发/难治性(Rel/Ref)多发性骨髓瘤患者进行了硼替佐米(Bor)联合地塞米松(Dex)治疗(BD Tx)的回顾性合作研究。一个周期的 BD Tx 包括在第 1、4、8 和 11 天给予 Bor(1.3 mg/m²/天),在第 1、2、4、5、8、9、11 和 12 天给予 Dex,每 21 天一次,BD Tx 的平均周期数为 3 个。总的缓解率为 66.9%,总生存(OS)中位数为 510 天,无进展生存(PFS)中位数为 113 天。首次 BD Tx 达到部分缓解(PR)与更长的 OS 和 PFS 以及晚期良好反应者相关,而首次周期未达到 PR 的患者在后续 BD Tx 中均未达到更好的非常好的缓解(VGPR)。年龄小于 64 岁的患者也与更长的 OS 和 PFS 相关。此外,疾病分期越早和地塞米松剂量越高对 OS 有显著影响,而在 2 个周期内达到 VGPR 则有显著更长的 PFS。早期 BD Tx 疗程可能对后续复发/难治性多发性骨髓瘤的治疗途径有预测作用。